[Hiring] Patient Account Representative 2 @University of Washington Medical Center

Role Description

UW Medicine’s Patient Financial Services has an outstanding opportunity for a Patient Account Representative 2.

WORK SCHEDULE: 40 hours per week, Day Shift

PRIMARY JOB RESPONSIBILITIES

• Edit, prepare, and submit UB-04, CMS-1500, ADA, and other applicable billing forms and electronic claims in accordance with regulatory requirements.
• Analyze and take appropriate action on unresolved insurance accounts, including denied, rejected, unpaid, underpaid, suspended, or otherwise unresolved claims.
• Perform insurance claim and account follow-up by researching claim status, payer processing requirements, eligibility, benefits, authorizations, medical necessity requirements, payment discrepancies.
• Review and analyze payer denials and claim rejections to determine the appropriate corrective action, including claim correction, rebilling, reconsideration, appeal, adjustment, or other payer follow-up necessary to resolve the account.
• Review the status of the entire patient account and exercise independent judgment to determine the appropriate course of action for resolution, considering claim history, payer responses, payments, adjustments, outstanding balances.
• Prepare and/or process Accounts Receivable adjustments in accordance with departmental policies, payer requirements, contractual terms, and established adjustment guidelines.
• Analyze insurance credit-balance accounts to determine the cause of the credit balance and take appropriate action to resolve payer overpayments, duplicate payments, payment posting discrepancies.
• Utilize available systems, payer portals, internal resources, and other reference materials to obtain and verify insurance eligibility, benefits, coverage, authorization, claim status, payment.
• Update patient demographic, insurance, and payer information in applicable systems to support accurate claim submission, payer processing, reimbursement, and account resolution.
• Communicate effectively with Medical Center staff and third-party payers as required to obtain, verify, and resolve billing, claim, eligibility, authorization, payment, and reimbursement information.
• Maintain spreadsheets, reports, and other tracking tools to support account follow-up, workload management, payer activity, reimbursement analysis, and departmental reporting; utilize Microsoft Excel, Word, and other applicable software to prepare correspondence and documentation.

Qualifications

• High School graduation or equivalent AND two years of experience in patient accounting, customer service, or a related office environment.
• Equivalent education and/or experience may substitute for minimum qualifications except when there are legal requirements, such as a license, certification, and/or registration.

Requirements

• Knowledge of UB, CMS 1500, ADA and other utilized billing forms and payer requirements.
• Knowledge of Epic Hospital Billing and/or SBO (a combination of hospital and professional) billing, and registration systems.
• Related office environments include Hospital or SBO: patient financial services, insurance billing, claims processing and follow-up, claims denials, appeals, underpayments or other business office settings involving patient account insurance billing and follow-up functions.

Benefits

• Pay Range Minimum: $23.41 hourly
• Pay Range Maximum: $33.47 hourly
• For information about benefits for this position, visit https://www.washington.edu/jobs/benefits-for-uw-staff/
• Shift: First Shift (United States of America)
• Temporary or Regular: This is a regular position
• FTE (Full-Time Equivalent): 100.00%
• Union/Bargaining Unit: SEIU Local 925 Nonsupervisory